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Silent Type

(8,253 posts)
3. That's the initial denial rate. Most -- like 80+ % -- get overturned on appeal. We have to figure out a better way of
Wed Dec 4, 2024, 05:20 PM
Dec 4

handling this.

Insurers definitely deny services that are needed. But, doctors do order tests, procedures, treatments, etc., that are not warranted.

The real guardrail to this -- absent laws that say services can't be denied -- is suing insurance companies. Lawyers love those cases when the evidence is that the denial was the cause or contributed to bad outcomes.

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